Organization Active NPI

JFJ Eyecare, LTD

Doing business as Quantum Vision Centers

  • Optometrist
  • Swansea, IL
National Provider Identifier
1376586685
Registry record updated Nov 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
JFJ EYECARE, LTD
Doing business as
Quantum Vision Centers
Practice address
3990 N Illinois St
Swansea, IL 62226
Phone
(636) 200-4393
Fax
(618) 277-6651
NPI assigned
Jun 14, 2006
Last updated
Nov 12, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
James WachterNPI 1689670697
Title
Cmo
Phone
(636) 200-4393

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

3990 N Illinois St
Swansea, IL 62226

Mailing address

PO Box 415000
Nashville, TN 37241-2019
Phone (636) 200-4393

Other practice location 1

4900 W Main St
Belleville, IL 62226-4725
Phone (618) 235-2400

Other practice location 2

1310 Dadrian Professional Park
Godfrey, IL 62035-1685
Phone (618) 433-5005

Other practice location 3

12 Professional Park Dr
Maryville, IL 62062-5672
Phone (618) 288-7266

Other practice location 4

2121 S State Route 157
Edwardsville, IL 62025-3607
Phone (618) 277-1130

Other practice location 5

400 N Broadway Ave
Salem, IL 62881-1514
Phone (618) 277-1130

Other names 1

  • Quantum Vision Centers Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, MO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040805000548 IL Part B Supplier - Clinic/Group Practice 8224009865 Receives reassigned benefits from 31 practitioners
Practice locations: Highland, IL; Effingham, IL; Maryville, IL; Mattoon, IL; Mount Vernon, IL; Pinckneyville, IL; Red Bud, IL; Salem, IL…
O20111026000149 MO Part B Supplier - Clinic/Group Practice 8224009865 Receives reassigned benefits from 5 practitioners
Practice locations: Saint Louis, MO; Hannibal, MO; Creve Coeur, MO; Chesterfield, MO

National Provider Directory

National Provider Directory
Tax ID family
The Ey Clinic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2121 S State Route 157
Edwardsville, IL 62025
Phone (618) 656-7774

2421 Corporate Ctr
Ste 102
Granite City, IL 62040
Phone (618) 451-7925

530 E Broadway St
Sparta, IL 62286
Phone (618) 443-4721

208 W Main St
Staunton, IL 62088
Phone (618) 635-3535

1402 S Grand Blvd
#G
Saint Louis, MO 63104

8031 West Florissant Ave
Ste C
Saint Louis, MO 63136
Phone (314) 222-2071

Practitioners & affiliated clinicians

Practitioners 41

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 41

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731369600000",
    "number": "1376586685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 415000",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372412019",
            "telephone_number": "636-200-4393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3990 N ILLINOIS ST",
            "city": "SWANSEA",
            "state": "IL",
            "postal_code": "62226",
            "telephone_number": "636-200-4393",
            "fax_number": "618-277-6651"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4900 W Main St",
            "address_purpose": "LOCATION",
            "city": "Belleville",
            "state": "IL",
            "postal_code": "622264725",
            "country_code": "US",
            "telephone_number": "618-235-2400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1310 Dadrian Professional Park",
            "address_purpose": "LOCATION",
            "city": "Godfrey",
            "state": "IL",
            "postal_code": "620351685",
            "country_code": "US",
            "telephone_number": "618-433-5005",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12 Professional Park Dr",
            "address_purpose": "LOCATION",
            "city": "Maryville",
            "state": "IL",
            "postal_code": "620625672",
            "country_code": "US",
            "telephone_number": "618-288-7266",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2121 S State Route 157",
            "address_purpose": "LOCATION",
            "city": "Edwardsville",
            "state": "IL",
            "postal_code": "620253607",
            "country_code": "US",
            "telephone_number": "618-277-1130",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "400 N Broadway Ave",
            "address_purpose": "LOCATION",
            "city": "Salem",
            "state": "IL",
            "postal_code": "628811514",
            "country_code": "US",
            "telephone_number": "618-277-1130",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "JFJ EYECARE, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-14",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A",
        "authorized_official_last_name": "WACHTER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "CMO",
        "authorized_official_telephone_number": "636-200-4393"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Quantum Vision Centers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Swansea, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.